Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Check with your doctor or hospital emergency room immediately if severe headache, stiff neck, chest pains, fast heartbeat, or nausea and vomiting occur while you are taking this medicine. These may be symptoms of a serious high blood pressure reaction that should have a doctor's attention.

When taken with certain foods, drinks, or other medicines, procarbazine can cause very dangerous reactions such as sudden high blood pressure. To avoid such reactions, obey the following rules of caution :

Do not eat foods that have a high tyramine content (most common in foods that are aged or fermented to increase their flavor), such as cheeses, yeast or meat extracts, fava or broad bean pods, smoked or pickled meat, poultry, or fish, fermented sausage (bologna, pepperoni, salami, and summer sausage) or other unfresh meat, or any overripe fruit. If a list of these foods and beverages is not given to you, ask your health care professional to provide one.

Do not drink alcoholic beverages or alcohol-free or reduced-alcohol beer or wine.

Do not eat or drink large amounts of caffeine-containing food or beverages, such as chocolate, coffee, tea, or cola.

Do not take any other medicine unless approved or prescribed by your doctor. This especially includes over-the-counter (OTC) or nonprescription medicine such as that for colds (including nose drops or sprays), cough, asthma, hay fever, appetite control; “keep awake” products; or products that make you sleepy.

After you stop using this medicine you must continue to obey the rules of caution concerning food, drink, and other medication for at least 2 weeks since procarbazine may continue to react with certain foods or other medicines for up to 14 days after you stop taking it.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

While you are being treated with procarbazine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Procarbazine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take or should not have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Procarbazine can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

Avoid contact sports or other situations where bruising or injury could occur.

For diabetic patients:

Procarbazine may affect blood sugar levels. While you are using this medicine, be especially careful in testing for sugar in your blood or urine.

If you are going to have surgery (including dental surgery) or emergency treatment tell the medical doctor or dentist in charge that you are using this medicine or have used it within the past 2 weeks.

Your doctor may want you to carry an identification card stating that you are using this medicine.